Peripheral Nerve Function Decline in an Aged Cohort

老年群体的周围神经功能下降

• 批准号: 7644421
• 负责人: Elsa S. Strotmeyer
• 金额: $ 52.57万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-15 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7644421
• 关键词: Accounting; Address; African American; Age; Age-Years; Aging; Ankle; Body Composition; Bone Density; Caucasians; Caucasoid Race; Characteristics; Clinical; Data; Demographic Factors; Deterioration; Diabetes Mellitus; Diagnosis; Elderly; Epidemiologic Studies; Epidemiology; Esthesia; Ethnic Origin; Goals; Health; Hemoglobin; High Prevalence; Hyperinsulinism; Impaired fasting glycaemia; Light; Link; Lower Extremity; Measures; Mediating; Mediator of activation protein; Motor; Muscle; Musculoskeletal; National Institute on Aging; Nerve; Neural Conduction; Neuropathy; Patient Self-Report; Peripheral; Peripheral Nerves; Peripheral Vascular Diseases; Peripheral arterial disease; Physical Examination; Population Study; Prevalence; Prevention; Recurrence; Reporting; Research Personnel; Risk Factors; Role; Sensory; Strategic Planning; Survivors; Testing; Time; Touch sensation; Upper arm; Vitamin B 12; Walking; Woman; age related; aged; bone loss; bone mass; bone strength; cohort; cost; diabetic; disability; falls; follow-up; functional decline; glucose metabolism; indexing; male; men; muscle strength; novel; peroneal nerve; population based; programs; prospective; sarcopenia; sex; vibration

DESCRIPTION (provided by applicant): Although poor peripheral nerve function is common in older age, the rate of decline with aging is unknown. Diabetes and other known causes of neuropathy appear to account for very little of the loss of nerve function with advancing age. We conducted a cross-sectional epidemiologic study of the prevalence and risk factors or poor peripheral sensory and motor nerve function in the Health, Aging and Body Composition (Health ABC) cohort. The Health ABC baseline cohort included 3075 men and women (42 percent African-American and 52 percent women). Of these, 1462 survivors aged 80-89 years of age are expected for their eleventh year follow- up exam. Longitudinal data from 2000-01 to 2007-08 will make it possible to determine whether nerve function declines are related to prospective lower extremity disability in 2008-10 and whether or not these associations are mediated by changes in muscle, bone density, and strength. We have documented cross- sectionally that peripheral nerve function is critical to their lower extremity function and mobility and is associated with muscle strength and bone density, demonstrating the importance of the peripheral nerves in sarcopenia and age-related disability. Analyses of numerous potential risk factors in Health ABC have revealed that age itself remains strongly related to poorer peripheral nerve function, even when accounting for established risk factors such as diabetes, and novel risk factors such as subclinical peripheral arterial disease and Caucasian race. To date, no U.S. study has reported the rate of decline in these aspects of peripheral nerve function with aging or has determined whether they precede lower extremity disability. The specific aims are to determine 1) declines in peripheral sensory and motor nerve function over six years and risk factors for these declines (demographic factors, vitamin B12 status, impaired glucose metabolism, subclinical peripheral arterial disease) in Caucasian and African-American older adults; and 2) if the rate of decline in peripheral sensory and motor nerve function is prospectively related to rate of recurrent falls and a decline in self-reported walking ability over two years. This study addresses many goals of the NIA, defined in its strategic plan, including prevention of disability, understanding age-related change and evaluating ethnic disparities. The Health ABC Study provides a unique and cost-effective opportunity to quantify and identify risk factors for decline in sensory and motor nerve function and relate these declines to prospective disability for the first time among a large group of older adults.

描述（由申请人提供）：虽然周围神经功能差在老年人中很常见，但随年龄增长而下降的速度尚不清楚。随着年龄的增长，糖尿病和其他已知的神经病变原因似乎只占神经功能丧失的很小一部分。我们对健康、衰老和身体组成（Health ABC）队列中外周感觉和运动神经功能不良的患病率和危险因素进行了横断面流行病学研究。健康ABC基线队列包括3075名男性和女性（42%的非裔美国人和52%的女性）。其中，1462名年龄在80-89岁的幸存者预计将进行第11年的随访检查。从2000-01年到2007-08年的纵向数据将有可能确定神经功能下降是否与2008-10年的预期下肢残疾有关，以及这些关联是否由肌肉、骨密度和力量的变化介导。我们横断面记录了周围神经功能对下肢功能和活动至关重要，并与肌肉力量和骨密度相关，证明了周围神经在肌肉减少症和年龄相关残疾中的重要性。对健康ABC中众多潜在危险因素的分析表明，即使考虑到糖尿病等已确立的危险因素，以及亚临床外周动脉疾病和高加索人种等新危险因素，年龄本身仍与周围神经功能较差密切相关。到目前为止，美国还没有研究报告这些方面的周围神经功能随着年龄的增长而下降的速度，也没有研究确定它们是否先于下肢残疾。具体目的是确定1)白人和非裔美国老年人6年内外周感觉和运动神经功能的下降以及这些下降的危险因素（人口因素、维生素B12状况、糖代谢受损、亚临床外周动脉疾病）；2)两年内外周感觉和运动神经功能的下降速度是否与跌倒复发率和自我报告的行走能力下降有潜在关系。本研究解决了NIA在其战略计划中定义的许多目标，包括预防残疾、了解与年龄相关的变化和评估种族差异。健康ABC研究提供了一个独特的和具有成本效益的机会来量化和确定感觉和运动神经功能下降的风险因素，并首次在一大群老年人中将这些下降与预期残疾联系起来。